315. Meet the Radiologist Leading AI Safety in Medical Imaging w/ Jaishree Naidoo | Envisionit

0:00Amardeep Parmar:Great to have you on today. Can you tell us who you are and what you're building? Thank you for having me. I'm Jaishree Naidoo, CEO, co-founder, radiologist for Envision at Deep AI. What I'm building, we have Rattify, which is our AI assurance and monitoring platform for Envision at. And what we do is we make sure that AI tools in medical imaging deliver on their promise for safety and accuracy. And that's done through Rattify. So I think I met you a couple of years ago now, right? Yes. Where are you today? Like, what's the progress at the moment? So where we are today is we've gone from a build stage and we have evolved through our journey, which I can share shortly.

0:45We're now in the growth stage where we're deploying Ratify and healthcare systems, monitoring AI tools, and actually seeing the evidence of the hard work we've put in through all these years. So it's the growth stage.

1:04Amardeep Parmar:And if it gave you the chance to brag, what are some of the numbers behind this? Where are you guys at now? I think when it comes to numbers, Ratify has already monitored more than 600 ,000 images and studies. So in medical imaging, and when you have an AI tool that provides an output, it. Ratify is that policeman, and it's already seen this. A really good number to share in terms of outcome is that one of our sites in the UAE, Ratify has brought down the quality assurance time from six minutes to five. So that's 80 % improvement. And where this can translate to is a productivity saving of$500 ,000 per radiologist.

1:50So just imagine, right, there are many AI tools in healthcare, but if you deploy safe AI tools, this is the outcome you can have in terms of productivity gains, return on investment. So that's what ratify is, not just proving the clinical value, accuracy value, but the financial value of a tool.

2:11Amardeep Parmar:I also know you've been on quite a journey throughout this process, right? In that you've had different iterations and pivots as well. Yes. How did it start off? What was the initial idea? So it takes us back to the why of when we started. And so going back to the beginning, seven years ago, I left a... I was very happy, but I left a career in pediatric radiology where I think I was at the height of my career in academia and in clinical. I'm a pediatric radiologist. And at that time, seven years ago, I was one of 20 pediatric radiologists in the continent, which is the youngest in the world. And to put this in perspective, it's Africa, where more than half the population is under the age of 15, where pneumonia is the number one cause of death in children under the age of five.

3:07And so there was this disparity that I saw and I couldn't unsee. And it was, there's the clinical need and the high disease burden, but the lack of specialist resources. And at that time, I knew technology can be used to help bridge this gap and can be transformative and can multiply my role as a radiologist. And so that's why I started Envision It in 2019. and we built AI tools in medical imaging. We deployed them in different resource environments, low resource, poor network capabilities in the back of trucks. We also got to go through the regulatory process, got our FDA, got ISO 13485. But during this experience, we got to see the positive side of AI, but also the negative.

4:05And what we did was build tools within our own AI tool to monitor, to check if there's drift, if there's bias, and to enable a doctor as an expert to audit the AI. And that's when the light bulb moment hit for us. It was, this is actually the missing layer in our industry, which is becoming really crowded. And this is the missing gap. And so we decided to pivot. And so our why evolved. And that is how Ratify was built. So Ratify incorporates an end-to-end monitoring and validation platform. And so we pivoted. So sometimes, you know, what you start out doing can transform, can evolve. And I think it still sticks to where we started out.

4:59Our purpose is enabling and democratizing access to safe diagnostic health care.

5:08Amardeep Parmar:So in your career as well before the startup, being one of the top radiologists in like a whole continent, I imagine that took a hell of a lot of work and also a lot of pressure as well right when you're one of the very few people who could do that and that transition like being able to move from obviously a very prestigious role that you worked really hard for into doing this how did you make that leap and obviously you knew that there was stuff needed but I guess also having a whole career that you built for so many years as well and leaving that behind in some ways how is that? It's not easy.

5:37I think for me, naturally, I'm a very driven person. It's who I am. I follow my purpose and passion. I never get comfortable with something. And, you know, when I decided to get into entrepreneurship, it was more to solve a challenge that I was feeling and that I felt that could be transformative. And so knowing that I'm following a purpose, it was easier for me. I'm also, I think, you know, resilience and tenacity is part of who I am. It's also what has accelerated my career. And I think that is a huge part of why I was able to make that transition a lot easier. And I still love what I do. I loved what I did when I was a pediatric radiologist in clinical service.

6:29but they got a point in time when I wanted to make changes in public health care and I was just constantly hitting balls and I realized that if I want to make this change I've got to do it myself and and so that moment came where I actually had to be bold and take that step and I did and there may be another opportunity but as long as I love what I do I think that's what keeps me grounded and helps me to pursue this.

7:02Amardeep Parmar:And so obviously coming into the startup world as an outsider, right, coming from a clinical background, what were some of the hardest things you had to learn in those early days? Oh, wow. There's a lot I had to learn. There's a lot that I continue to learn. And I love learning. I love growing in many aspects, right? So leadership, there's things I needed to learn being a leader. There's many things I needed to learn about myself, working in a team, about technology. So when it comes to leadership, one of the things I've had to learn is, you know, I spoke about resilience and tenacity, but I've also learned that resilience comes in, in the quiet moments.

7:45It's so easy when you're building a company and where everything is important and everything is urgent, is to just continue that pace. But I found, you know, the biggest change or the greatest insights I've had as a leader is when I paused, I reflected, and I looked at the opportunity or a challenge with a different perspective. And so it's those pausing moments that has been a spark, I would say, an inspirational spark. In my leadership experience, I've also learned a lot about myself, a lot about my own strengths, but my gaps and those edges are when, as someone who's naturally driven, I like to get things done.

8:40and sometimes that can be a problem and I have had to learn and I think I constantly continue to learn to allow my team and trust in them to stand in their own strengths and I think that's important. I've always believed in the whole is greater than the sum of the parts. When you have shared values, different perspectives, you can build a better company, a better product. And so that's a continuous learning. Yeah, I think it's the same with building a product, you know, different perspectives. I come from the clinical experience, and I put that into the product, right? It comes from a lived experience, and that's ratified too.

9:30It comes from a lived experience, both in my clinical time as a radiologists, but also as Envisionit, the entire team, we've got the experience of building AI tools, deploying it, going through regulatory, and we put all of that experience into our product. So that's amazing. I'm very proud of that.

9:51Amardeep Parmar:You mentioned a team there as well, and obviously you've been a co-founder. Can you tell us about that relationship and how that all came about? And that's also one of the reasons why I would say it made it easier for me to transition from the clinical to entrepreneurship. My co-founder, one of my co-founders, is also my husband. And I've watched him for many years as a serial entrepreneur in the finance. He's got the finance background. And my other co-founder is in the technology background. So I think the three of us have more than 20 years of experience in the different domains, and we learn from each other.

10:37So that's the beauty of our partnership, is that I've got to learn a lot about finance, managing capital, technology, and how technologists think. and they've got to learn a lot from my experience working in a hospital. And that was instrumental in our product because we've always built with the end in mind. And those are the learnings I've learned from my co-founder is that it's not always about a product. You have to look at a product from different perspectives, right? Yes, you can build an amazing tool or innovation. But if you don't think about what is your go-to-market strategy? How are you going to sell the product?

11:19That's all very important.

11:21Amardeep Parmar:And then how did you get that first customer, make that first sale? The first sale was actually I gave a talk about our AI tool at a conference in 2020, just before COVID. And one of the CEOs at the hospital heard about what I was doing and wanted to understand the product. And it was the right moment at the right time with the right CEO who was thinking forward about bringing innovation in healthcare. And we started with a pilot and we got to show the evidence of how it worked. So I think having that lens as a radiologist, so clinical background and being able to articulate to my peers who I'm selling to helps.

12:14Amardeep Parmar:And with that pilot at the beginning, because I think whenever it's in healthcare, people always try to figure out how do you price things? How long should you do a pilot for? How do you figure that out? And I guess how does that also evolve over time? Yeah, I don't think I have it all figured out. But that's something I've seen is an issue with AI tools, right? There's something that's called pilotitis. And again, bringing back my, you know, my background as a radiologist, I know that doctors practice evidence-based medicine. And what I found was you can continue to have a pilot, but what slows down adoption is that trust factor.

12:56If the doctors don't enjoy your tool, don't see that it's making a difference in their workflow, and they cannot trust it, they're not going to adopt it. And you can continue having a pilot. So once you're able to bridge that, show them the evidence. And once you start solving a challenge, rather than selling a product, and that's another thing, I think people tend to sell their products and how amazing it is. It's something I've had to learn as well. So once you start selling, not selling, but trying to address a challenge to your end user, that's when they see the effect it is. And it's how you're able to now sell your product.

13:38It's all about solving a challenge for them. And you have to think about that rather than you and how amazing your innovation is.

13:48Amardeep Parmar:Did you start off in South Africa? Where did you start? And then obviously now living here, how did you think about that global expansion, the geographic regions to focus on? Yeah, I think, so it was just post-COVID. We were appointed, we were part of the South African Tech Hub. And we're appointed to the UK Tech Hub through the Department for Business and Trade. We got appointed into the Global Entrepreneur Program. And we wanted to then move our HQ in the UK because during COVID, we actually got to realize that the world is quite a small place. the same challenges we built solutions for existed in the NHS.

14:31There is a shortage of doctors. Adoption of AI needs to improve by bridging that trust gap. So that is why we decided to move to the UK and settle and have our HQ here. It was an easy decision, I would say, because firstly time zones that is easier the global entrepreneur program actually helped us with a lot of the logistical support the soft landing and I knew I wanted to be in a country that supports innovation and that also supports trusted innovation and that's where I saw a lot of alignment. We wanted to build a global company, but still solve the challenges in Africa. And that hasn't changed.

15:24Amardeep Parmar:Hello, hello. I hope you've enjoyed the show so far. I'm Amadeek Parma, co-founder of BayHQ and the host of this show. For those of you who don't know, BayHQ is the community for high growth Asian heritage founders and investors in the UK. Over 7 ,500 people have attended our events. 200 people have been through our impact programs and obviously there's been over 250 episodes of this podcast. If you want to join us and take part in the programs and come to the events go to bahiehq.com forward slash join. We also just released our first ever book called Startups for Outsiders which you can get on Amazon now and the link is in the bio.

16:06Amardeep Parmar:Hope to see you soon at our event. Hope you enjoy the rest of the episode. what's been the differences between say you're selling in south africa and selling in the uk or different attitudes have you found you have to use different tactics in different places definitely different attitudes but ultimately it comes back to the end user there are many differences but in many ways there's also quite a few similarities you're still speaking to the same client that cares about their challenges so whether you're in the uk whether you're in South Africa, it's about solving their challenges. And that's quite unique.

16:43South Africa, I would say in terms of adopting AI is slower. It has changed recently. So whereas the UK has been more ahead in terms of innovation, it was easier to describe the solutions that we have, whereas in South Africa requires a little bit more time on educating. But I think, you know, that has changed recently. We're seeing AI tools being adopted more frequently. Now there's education about how do you choose the right solution for your geography, for your patient population. And that requires a lot of education, especially in South Africa, where you could have many organizations coming in into Africa because the data is rich.

17:35And I think it's overcrowded. For us, there's a great opportunity to guide South Africa. And in the UK, where it's more AI mature, there's a great opportunity for Ratify to monitor all the solutions that are already being deployed and prevent this pilotitis, right? Enable AI companies to actually go to market faster. So that's where we sit. We're in the middle. We're empowering healthcare systems and hospitals to deploy the right and trusted AI tools, but we're also empowering our AI vendors and startups to get to market faster.

18:18Amardeep Parmar:How does it work in terms of business model there as well? So you're obviously sitting in the middle there. How does that work? The way it works is we love to take a partnership approach to this. Again, coming back to the whole is greater than the sum of the parts. I love saying that. We love partnering because what we have is a solution that bridges. So we understand healthcare systems and hospitals and hospital CEOs and radiologists and their needs. We also understand AI and AI vendors and their needs. So we're sitting in that middle layer where there's increased risk. There's also that trust gap.

19:00And I think that's a comfortable place for us from our experience. So Envision.it is led by a radiologist as well as Envision.it has the experience of building AI tools. So for us, I think that's that middle layer that we're helping to bridge.

19:21Amardeep Parmar:So I think it must have been a couple of months ago. Did I answer that? I think I got lost to this. I guess it was, so the question was a bit more about, how do you make money, basically? Oh, is that... It's like, what's the best way about business model in terms of that? Oh, business model, sweet. Oh, okay. I was going to let you get away with it. Maybe she doesn't want to say it. I didn't, yeah, I didn't realise. Yeah, I think it's the partnership part, right? So we work with marketplaces, we work with OEMs, and that helps us with a go-to-market strategy. We have a dual go-to-market strategy, is direct sales, but also the partnership model.

20:05And the partnership model really helps to scale, ratify, so that it can be in modalities, OEMs, for example, big manufacturers of radiology equipment, but AI marketplaces. partner with AI vendors as well. It gives us the diversity.

20:22Amardeep Parmar:That's been a couple of months ago now. I saw you pitching at the Morgan Stanley Sustainable Inclusive Ventures program, right? And obviously you're great on stage and you're in the stage and everyone's clapping everything. And how has that funding journey been for you? So obviously you've got some backing there, but you've had backing in the past as well. When we started Envision It, we bootstrapped for the first four years. we put our money and we backed ourselves and we will continue to do that we raised capital through a private equity ran merchant bank ventures from South Africa a big private equity and that was in 2022 at the end of 2022 that helped us get our regulation raising raising capital isn't easy it's something I would say it's a bit challenging in the space because there's a lot of focus on AI tools and the hype around AI and I would say compliance and monitoring and validation doesn't sound as sexy so it makes it a lot more challenging when we decided and when we saw this as a big gap three years ago no one was talking about AI safety but you go to any conference now everyone speaks about AI safety and I know this is going to change and what we've built we saw this three years ago and we've had the time and the experience to build something that is going to be transformative it is already showing examples of it so I'm not concerned too much about that because we will continue to back ourselves.

22:12I'm just looking for the right investor, the right investor that wants to join us on this journey in shaping the future for responsible AI. That's more important to me because it's not about just the capital. um i want the part it's a partnership and i'm looking for a partner that sees this as the future and that can support us it's interesting too because there's not too many early stage companies will go to private equity early on so how is that just a nature of like being first-time

22:50Amardeep Parmar:founders and understanding that how did that kind of work out there i think it's the nature of who we are, that we come from a background with, you know, 20 years myself in radiology, and it's from Terence's background. Terence, you know, has been 20 years in the field in private equity as well. So it's about your network. Your network is your net worth. So it comes from that. I have said this to many people in there, you went to private equity before angels. So we bypassed the angels, and we may still raise from angels now, we do things differently. I think we have that confidence because of our experience is that whatever happens, it's okay.

23:37We don't have to follow a certain trajectory as long as we believe in what we're doing. If the right investor comes along, we're not going to say no. If there is a shared value and a shared purpose, We're not going to say no. And so if it is a private equity investor first, great. And they've been very supportive. Red Merchant Bank Ventures has been very supportive through our journey.

24:07Amardeep Parmar:And looking at the future as well. So you said, obviously, you saw this problem for years ago in terms of the pivot. What's the hope for this? What do you someday wish that this is where Envision it gets to? What's the vision for Envision? I think what I would love to see in two years or maybe even shorter, is that ratify becomes this accepted, approved standard for trust in healthcare AI. When you ask someone, instead of asking them, you know, what does your AI tool do? You're going to ask, has it been ratified? That's what I want to see. It's all about responsible AI because ultimately it's about patients benefiting.

24:57What I would love to see and hear people talk about is we've used Ratify to help us deploy this tool that is making a life-saving decision for our patients and benefiting patients. But we've also used Ratify to tell us that this particular tool was not the right tool for our hospitals. We've used Ratify and radiologists and hospital clinicians are going to say, I now have the confidence and trust in AI because I used Ratify to help me evaluate this AI tool.

25:37Amardeep Parmar:And obviously you've seen how AI safety is going to be a bigger deal, right? And looking at the market and the trends as well, you're sitting in an interesting place that you said because you're going to see what's happening on the hospital side, what's happening on the AI side. what are you seeing in terms of like where do you envision like where do you envision yeah where do you envision the market going when people think about how quickly AI is going to be adopted in healthcare are you bullish or do you think it's going to take a few years where do you kind of see that I think it's um the the future is crowded um I think we're already seeing we're being bombarded with the latest innovation, the latest around AI, agentic AI.

26:19And this is going to continue to accelerate. But I feel that trust is going to become the differentiator. And you're starting to see people talk about this a lot more. And I do believe that we're going to actually in the future go back to what makes us human and human judgment is going to stand out because you're going to have the latest innovation but the best innovation and the best tools are going to be the ones that are trusted and tried out and validated. I think that's where we're going to go in the future and Rattify is built for that.